Your Rural Internet Connection Might Save Your Life: Telemedicine

There’s a silent threat rising across the nation, and you may be at risk. More and more people in rural areas and small towns are losing access to healthcare. Rural hospitals and rural clinics are closing down, creating shortages of primary care providers and specialists [1].

Some rural residents already have to travel two hours or more just to reach a primary care provider. If you’re facing that problem, you might decide to give up and stop going to the doctor.

If you don’t get regular healthcare, your health may be in jeopardy. But there’s a solution—you can visit your doctor virtually through your internet connection.

Virtual doctor visits are known as “telemedicine.” When you can’t get to the doctor in person, telemedicine might even save your life.

Is Your Healthcare at Risk? Try Telemedicine

Hawaiians using telemedicine: 1 in 3

The Rural Healthcare Crisis in Each U.S. State

Many people don’t have the budget, time off, or transportation to travel long distances to visit a doctor in person. People in rural areas may miss crucial screenings for cancer and diabetes. Their injuries or chronic conditions can fester and get worse.  Even pregnant women sometimes can’t see an OB/GYN without traveling hours from their home [2].

RISK FACTORS FOR HEALTHCARE ACCESS

Your risk of going without healthcare will be greater if you live in a state with many healthcare shortage areas [3].The federal government has defined these shortage areas by geographical area, which can be measured by county subdivision or census tract. A geographical shortage area means that everyone in the area is affected by the lack of healthcare providers.

Some states have also seen large numbers of rural hospital closures, with even more closures coming soon [4].

Millions of people living outside major urban areas qualify as rural population [5]. Living in less-populated areas increases the odds that you might lose healthcare access.

Our maps depict all three of these risk factors in every U.S. state, based on data from the U.S. Census, the HRSA, and other government agencies and research centers. Click on the tabs to see Primary Care Healthcare Provider Shortage Areas (HPSAs), rural hospital closures since 2005, and total rural population in each state.

Telemedicine: virtual doctor visits

Lifesaving Telemedicine Delivered Over Rural Internet

If you have a rural internet connection, you can use telemedicine. Telemedicine means seeing your doctor virtually, often by using a video call through your home internet. Even if your local clinic closes, you can get crucial online healthcare, screenings, and even emergency care through telemedicine.

We’ve collected the data on who is most at risk for lacking healthcare. We’ll show you the top 20 states that have the highest risk factors. But the unfortunate truth is that almost all states are steadily losing healthcare access for rural residents. If you scroll over our map, you’ll see that the vast majority of U.S. states have significant shortages and closures.

Our fourth risk factor map will show you which states are using telemedicine most and least [6]. Telemedicine usage can be a hopeful sign in states where usage is high and as many as 1 in 3 people use telemedicine in some way. But low usage is a warning sign for states where only 1 in 10 people have gone to the doctor virtually. Low telemedicine usage means that fewer people in that state will know how to use telemedicine through a home internet connection. And those low-usage states are often the ones with the most need of better healthcare access.

Top Twenty States that Most Need Telemedicine for Rural Healthcare

We weighed our first 3 risk factors to analyze which states have the highest chance of needing telemedicine for their rural residents. Texas is the top state for healthcare risk, taking the first slot across the board with 154 shortage areas, 29 rural hospital closures since 2005, and over 4.7 million people in its rural population. Alabama also scored high for healthcare risk, with 51 shortage areas, 7 rural hospital closures, and a rural population of 2.1 million.

But the highest-risk states aren’t all along the southern border. Here are the top 20.

Best and Worst States for Telemedicine Usage

States are making progress if they already show high usage of telemedicine by their residents. But of all the high-usage states where at least 1 in 4 people are using telemedicine, only California is also on the “states that most need telemedicine” list.

Seven Dangerous Conditions That Telemedicine Can Treat

Cardiac rehab — Recovery and extended life after a heart attack can depend heavily on your rehab, with maintenance that must go on for months. At-home rehab can happen with telemedicine through video doctor visits and smart devices to monitor your vital signs.

Diabetes management – Diabetes is another widespread chronic condition in which weekly management can make the difference in whether you survive and live a full life. Having diabetes support from your healthcare team through videoconferencing when you can’t get into the hospital is a game-changer [7].

Telemedicine can help keep track of your welfare and your unborn baby’s health

Obstetrics care – It’s always better to have in-person care during a pregnancy, but that may be impossible due to distance and transportation issues. The next best alternative is telemedicine for hybrid care. Smart devices and videoconferencing can assist your healthcare professional to keep track of your welfare and your unborn baby’s health [2].

Stroke services—Videoconferencing in an urgent situation can help your provider identify whether you may be suffering from a stroke. Telestroke care can expedite transportation and treatment.

Emergency triage and post-emergency care –If you are injured or very ill, you may live too far for anything but a helicopter trip to get you to the hospital. A virtual triage with a doctor or nurse can help you determine if you need that helicopter. They can also assist you in controlling blood loss or damage to your body before emergency help arrives.

Dermatology – At first, skin care may not sound important compared to these other issues, but skin cancer is a silent killer. With the help of a video exam, a dermatologist can catch a very serious problem in time for a good outcome, even if you can’t make it to the clinic for an in-person exam.

Mental health/behavioral health – Treatment for mental illness or addiction can get more difficult with every mile you have to travel to get help [8]. Telehealth for psychiatry and counseling support can change your life if you live far from in-person assistance or don’t have transportation [9]. Doctors can even prescribe emergency prescription treatment by remote appointments.

Who Should Use Telemedicine?

Everyone can use telemedicine when it is convenient and appropriate. Some states will allow patients to receive telemedicine treatment by voice call only, but many require a video session with the provider. All fifty states allow reimbursement for a live video telemedicine session, which means your doctor will be more willing to offer care that way [10].

Some state telemedicine policies require private insurance to pay your provider the same fee for a telemedicine appointment as for an in-person appointment [11]. That “payment parity” policy encourages the availability of telemedicine in your state.

Visit your nearest clinic’s doctors online

Where to Find Telemedicine Services

Often, the hospital or clinic closest to your home may offer telemedicine, if you are in a rural area. This facility will often be your best choice, as a brick-and-mortar hospital can offer you hybrid care or in-person care in addition to virtual care.

Telemedicine usage skyrocketed during the pandemic. As a result, there are now online services that will network you with doctors in a variety of specializations. One of the largest is Teladoc, which provides licensed doctors in all fifty states in primary care, non-emergency care, mental health therapy and nutrition. Other companies include Amwell and Doctor on Demand. Just be sure you understand the fees and billing before you book an appointment.

If your coverage is through Medicare, you can currently get telemedicine anywhere in the United States where the provider accepts Medicare and offers virtual visits. That coverage will last until December 2024 unless the federal government extends the sunset deadline beyond that point [12].

Medicaid telehealth coverage will vary by state. Your provider will usually be aware of your state rules, as their payment depends on your state policies.

Satellite internet reaches rural areas

How to Get Internet in Rural Areas

The easiest and most reliable way to get healthcare virtually is to have a home internet connection to support your doctor visits and any paperwork. In rural areas, your options for internet providers may be limited.

Satellite internet is often the most reliable form of internet in rural areas. Over 99% of the population in the U.S. can get satellite internet in their homes. So, if you don’t have cable or fiber infrastructure in your area, you can still use telemedicine.

 Payment Assistance for Your Internet Plan

Having an internet connection at home is an important form of equity in today’s world. Because federal and state governments recognize that need, you can get support for your monthly internet payment.

The FCC’s Affordable Connectivity Program will help qualifying households with payment assistance of $30/month toward your internet bill. Qualifying households on tribal lands can receive assistance of $75/month [13].

[1] CHCS.org. “Telehealth in Rural America.”

[2] Advisory.com. “How to mitigate the long-term effect of OB unit closures.”

[3] Health Resources and Services Administration. “Health Workforce Shortage Areas.”

[4] UNC Sheps Center. “Rural Hospital Closures.”

[5] U.S. Census 2020 – 2022. “State Population Totals.”

[6] CDC.gov. “Household Pulse Survey of Telemedicine Use.”

[7] CDC.gov. “Telehealth in Rural Communities.”

[8] Department of Health and Human Services. “Telehealth and Behavioral Health.”

[9] Psychiatry.org. “Telepsychiatry.”

[10] CCHPCA.org. “State Telehealth Laws.”

[11] CCHPCA.org. “Policy Trends.”

[12] Medicare.gov. “Telehealth Insurance Coverage.”

[13] FCC.gov. “Affordable Connectivity Program.”